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Incidence of Hypoxic Hepatitis in Patients with Cardiogenic Shock and Association with Mortality

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Incidence of Hypoxic Hepatitis in Patients with Cardiogenic Shock and Association with Mortality. / Beer, Benedikt N; Besch, Lisa; Weimann, Jessica; Surendra, Kishore; Roedl, Kevin; Grensemann, Jörn; Sundermeyer, Jonas; Dettling, Angela; Kluge, Stefan; Kirchhof, Paulus; Blankenberg, Stefan; Scherer, Clemens; Schrage, Benedikt.

In: EUR HEART J-ACUTE CA, Vol. 12, No. 10, 25.10.2023, p. 663-670.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Beer, BN, Besch, L, Weimann, J, Surendra, K, Roedl, K, Grensemann, J, Sundermeyer, J, Dettling, A, Kluge, S, Kirchhof, P, Blankenberg, S, Scherer, C & Schrage, B 2023, 'Incidence of Hypoxic Hepatitis in Patients with Cardiogenic Shock and Association with Mortality', EUR HEART J-ACUTE CA, vol. 12, no. 10, pp. 663-670. https://doi.org/10.1093/ehjacc/zuad076

APA

Beer, B. N., Besch, L., Weimann, J., Surendra, K., Roedl, K., Grensemann, J., Sundermeyer, J., Dettling, A., Kluge, S., Kirchhof, P., Blankenberg, S., Scherer, C., & Schrage, B. (2023). Incidence of Hypoxic Hepatitis in Patients with Cardiogenic Shock and Association with Mortality. EUR HEART J-ACUTE CA, 12(10), 663-670. https://doi.org/10.1093/ehjacc/zuad076

Vancouver

Beer BN, Besch L, Weimann J, Surendra K, Roedl K, Grensemann J et al. Incidence of Hypoxic Hepatitis in Patients with Cardiogenic Shock and Association with Mortality. EUR HEART J-ACUTE CA. 2023 Oct 25;12(10):663-670. https://doi.org/10.1093/ehjacc/zuad076

Bibtex

@article{ea2f78651bb24c86940ca29855ce8a67,
title = "Incidence of Hypoxic Hepatitis in Patients with Cardiogenic Shock and Association with Mortality",
abstract = "AIMS: Shock of any cause leads to end-organ damage due to ischaemia, especially in perfusion-sensitive organs such as the liver. In septic shock, hypoxic hepatitis (S-HH) is defined as the 20-fold increase of the upper normal limit of aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) and is associated with a mortality of up to 60%. However, as pathophysiology, dynamics, and treatment differ between septic and cardiogenic shock (CS), the S-HH definition may not be suitable for CS. Therefore, we aim to evaluate if the S-HH definition is applicable in CS patients.METHODS AND RESULTS: This analysis was based on a registry of all-comer CS patients treated between 2009 and 2019 at a tertiary care centre with exclusion of minors and patients without all necessary ASAT and ALAT values. N = 698. During in-hospital follow-up, 386 (55.3%) patients died. The S-HH was not significantly associated with in-hospital mortality in CS patients. To define HH among patients with CS (C-HH), optimal cut-off values were found to be ≥1.34-fold increase for ASAT and ≥1.51-fold increase for ALAT in serial measurements. The incidence of C-HH was 254/698 patients (36%) and C-HH showed a strong association with in-hospital mortality (odds ratio 2.36, 95% confidence interval: 1.61, 3.49).CONCLUSION: The C-HH is a frequent and relevant comorbidity in patients with CS, although its definition varies from the established definition of HH in patients with septic shock. As C-HH contributed to excess mortality risk, these findings emphasize the need for further investigation of therapies reducing the occurrence of C-HH and also improving the associated outcome.",
author = "Beer, {Benedikt N} and Lisa Besch and Jessica Weimann and Kishore Surendra and Kevin Roedl and J{\"o}rn Grensemann and Jonas Sundermeyer and Angela Dettling and Stefan Kluge and Paulus Kirchhof and Stefan Blankenberg and Clemens Scherer and Benedikt Schrage",
year = "2023",
month = oct,
day = "25",
doi = "10.1093/ehjacc/zuad076",
language = "English",
volume = "12",
pages = "663--670",
journal = "EUR HEART J-ACUTE CA",
issn = "2048-8726",
publisher = "SAGE Publications",
number = "10",

}

RIS

TY - JOUR

T1 - Incidence of Hypoxic Hepatitis in Patients with Cardiogenic Shock and Association with Mortality

AU - Beer, Benedikt N

AU - Besch, Lisa

AU - Weimann, Jessica

AU - Surendra, Kishore

AU - Roedl, Kevin

AU - Grensemann, Jörn

AU - Sundermeyer, Jonas

AU - Dettling, Angela

AU - Kluge, Stefan

AU - Kirchhof, Paulus

AU - Blankenberg, Stefan

AU - Scherer, Clemens

AU - Schrage, Benedikt

PY - 2023/10/25

Y1 - 2023/10/25

N2 - AIMS: Shock of any cause leads to end-organ damage due to ischaemia, especially in perfusion-sensitive organs such as the liver. In septic shock, hypoxic hepatitis (S-HH) is defined as the 20-fold increase of the upper normal limit of aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) and is associated with a mortality of up to 60%. However, as pathophysiology, dynamics, and treatment differ between septic and cardiogenic shock (CS), the S-HH definition may not be suitable for CS. Therefore, we aim to evaluate if the S-HH definition is applicable in CS patients.METHODS AND RESULTS: This analysis was based on a registry of all-comer CS patients treated between 2009 and 2019 at a tertiary care centre with exclusion of minors and patients without all necessary ASAT and ALAT values. N = 698. During in-hospital follow-up, 386 (55.3%) patients died. The S-HH was not significantly associated with in-hospital mortality in CS patients. To define HH among patients with CS (C-HH), optimal cut-off values were found to be ≥1.34-fold increase for ASAT and ≥1.51-fold increase for ALAT in serial measurements. The incidence of C-HH was 254/698 patients (36%) and C-HH showed a strong association with in-hospital mortality (odds ratio 2.36, 95% confidence interval: 1.61, 3.49).CONCLUSION: The C-HH is a frequent and relevant comorbidity in patients with CS, although its definition varies from the established definition of HH in patients with septic shock. As C-HH contributed to excess mortality risk, these findings emphasize the need for further investigation of therapies reducing the occurrence of C-HH and also improving the associated outcome.

AB - AIMS: Shock of any cause leads to end-organ damage due to ischaemia, especially in perfusion-sensitive organs such as the liver. In septic shock, hypoxic hepatitis (S-HH) is defined as the 20-fold increase of the upper normal limit of aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) and is associated with a mortality of up to 60%. However, as pathophysiology, dynamics, and treatment differ between septic and cardiogenic shock (CS), the S-HH definition may not be suitable for CS. Therefore, we aim to evaluate if the S-HH definition is applicable in CS patients.METHODS AND RESULTS: This analysis was based on a registry of all-comer CS patients treated between 2009 and 2019 at a tertiary care centre with exclusion of minors and patients without all necessary ASAT and ALAT values. N = 698. During in-hospital follow-up, 386 (55.3%) patients died. The S-HH was not significantly associated with in-hospital mortality in CS patients. To define HH among patients with CS (C-HH), optimal cut-off values were found to be ≥1.34-fold increase for ASAT and ≥1.51-fold increase for ALAT in serial measurements. The incidence of C-HH was 254/698 patients (36%) and C-HH showed a strong association with in-hospital mortality (odds ratio 2.36, 95% confidence interval: 1.61, 3.49).CONCLUSION: The C-HH is a frequent and relevant comorbidity in patients with CS, although its definition varies from the established definition of HH in patients with septic shock. As C-HH contributed to excess mortality risk, these findings emphasize the need for further investigation of therapies reducing the occurrence of C-HH and also improving the associated outcome.

U2 - 10.1093/ehjacc/zuad076

DO - 10.1093/ehjacc/zuad076

M3 - SCORING: Journal article

C2 - 37410589

VL - 12

SP - 663

EP - 670

JO - EUR HEART J-ACUTE CA

JF - EUR HEART J-ACUTE CA

SN - 2048-8726

IS - 10

ER -